Case A26041021

A. DEAN · 2026 · Case ID: A26041021

DENIED

Summary

The veteran, who served from December 1995 to December 1999, appeals the denial of service connection for a neck disorder, a back disorder, rhinitis, sinusitis, and migraine headaches. The Board of Veterans' Appeals reviewed the evidence of record at the time of the initial rating decisions. For the neck disorder, the Board found no current diagnosis or evidence of a neck disorder during the pendency of the claim. For the back disorder, rhinitis, sinusitis, and migraine headaches, the Board found no evidence establishing a causal or etiologic relationship to any disease, injury, or incident during service. The Board cited the requirements for direct service connection, which include evidence of a current disability, in-service incurrence or aggravation, and a nexus between the in-service event and the current condition. The decision noted that if new evidence was submitted after the rating decisions, it would not be considered and advised the veteran to file a Supplemental Claim. Ultimately, the Board denied service connection for all five conditions, concluding that the criteria for service connection were not met for any of them.

Rationale

No current diagnosis of neck disorder; No evidence of in-service incurrence or aggravation; No nexus to service established

Special Benefit

NO SPECIAL BENEFIT

Docket No.

250417-534935

Full Decision Text

Citation Nr: A26041021
Decision Date: 04/30/26 Archive Date: 04/30/26

DOCKET NO. 250417-534935
DATE: April 30, 2026

ORDER

Service connection for a neck disorder is denied.

Service connection for a back disorder is denied.

Service connection for rhinitis is denied.

Service connection for sinusitis is denied.

Service connection for migraine headaches is denied.

FINDINGS OF FACT

1. At no time during the pendency of the claim does the Veteran have a current disability of a neck disorder, and the record does not contain a recent diagnosis of such disability prior to the Veteran's filing a claim.

2. A back disorder is not shown to be causally or etiologically related to any disease, injury, or incident during service.

3. Rhinitis is not shown to be casually or etiologically related to any disease, injury, or incident during service.

4. Sinusitis is not shown to be casually or etiologically related to any disease, injury, or incident during service.

5. Migraine headaches are not shown to be casually or etiologically related to any disease, injury, or incident during service.

CONCLUSIONS OF LAW

1. The criteria for service connection for a neck disorder have not been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303.

2. The criteria for service connection for a back disorder have not been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303.

3. The criteria for service connection for rhinitis have not been met. 38 U.S.C.

§§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303.

4. The criteria for service connection for sinusitis have not been met. 38 U.S.C.

§§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303.

5. The criteria for service connection for migraine headaches have not been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran has active duty service from December 1995 to December 1999.

This matter comes before the Board of Veterans' Appeals (Board) on appeal from rating decisions issued in March 2025 and April 2025 by a Department of Veterans Affairs (VA) Regional Office (RO) under the modernized appeals system known as the Appeals Modernization Act (AMA), which denied service connection for a neck disorder, a back disorder, rhinitis, sinusitis, and migraine headaches, respectively. In April 2025, the Veteran timely appealed such rating decisions by submitting a Decision Review Request: Board Appeal (Notice of Disagreement) (VA Form 10182) and requested direct review of the evidence considered by the Agency of Original Jurisdiction (AOJ).

Therefore, the Board may only consider the evidence of record at the time of the March 2025 AOJ decision relative to the issue of entitlement to service connection for a neck disorder, and at the time of the April 2025 AOJ decision relative to the issues of entitlement to service connection for a back disorder, rhinitis, sinusitis, and migraine headaches. 38 C.F.R. § 20.301. If evidence was submitted during the period after the AOJ issued the decision, the Board did not consider it in its decision. 38 C.F.R. §§ 20.300, 20.301, 20.801.

If the Veteran would like VA to consider any evidence that was submitted that the Board could not consider, he may file a Supplemental Claim (VA Form 20-0995) and submit or identify this evidence. 38 C.F.R. § 3.2501. If the evidence is new and relevant, VA will issue another decision on the claim, considering the new evidence in addition to the evidence previously considered. Id. Specific instructions for filing a Supplemental Claim are included with this decision.

Service Connection.

Service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303(a). Service connection may also be granted for any disease diagnosed after discharge, when all of the evidence, including that pertinent to service, establishes
al Claim (VA Form 20-0995) and submit or identify this evidence. 38 C.F.R. § 3.2501. If the evidence is new and relevant, VA will issue another decision on the claim, considering the new evidence in addition to the evidence previously considered. Id. Specific instructions for filing a Supplemental Claim are included with this decision.

Service Connection.

Service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303(a). Service connection may also be granted for any disease diagnosed after discharge, when all of the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d). Direct service connection may not be granted without evidence of a current disability; in-service incurrence or aggravation of a disease or injury; and a nexus between the claimed in-service disease or injury and the present disease or injury. Id.; see also Caluza v. Brown, 7 Vet. App. 498, 506 (1995) aff'd, 78 F.3d 604 (Fed. Cir. 1996).

Where a veteran served for at least 90 days during a period of war or after December 31, 1946, and manifests certain chronic diseases, such as migraine headaches, to a degree of 10 percent within one year from the date of termination of such service, such disease shall be presumed to have been incurred or aggravated in service, even though there is no evidence of such disease during the period of service. 38 U.S.C. §§ 1101, 1112, 1137; 38 C.F.R. §§ 3.307, 3.309. Alternatively, when a disease at 38 C.F.R. § 3.309(a) is not shown to be chronic during service or the one-year presumptive period, service connection may also be established by showing continuity of symptomatology after service. 38 C.F.R.

§ 3.303(b). However, the use of continuity of symptoms to establish service connection is limited only to those diseases listed at 38 C.F.R. § 3.309(a) and does not apply to other disabilities which might be considered chronic from a medical standpoint. See Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013).

Additionally, rhinitis and sinusitis shall be service-connected even though there is no evidence of such disease during the period of service if it becomes manifest to any degree (including noncompensable) within 10 years from the date of separation from military service that includes a qualifying period of service in Southwest Asia during the Persian Gulf War, or Afghanistan, Syria, Djibouti, or Uzbekistan on or after September 19, 2001, during the Persian Gulf War. Such further provides that a veteran who has such a qualifying period of service shall be presumed to have been exposed to fine, particulate matter during such service. 38 C.F.R. § 3.320(a)(1), (2). As to the 10-year manifestation rule, it is noted that VA issued a final rule to revise 38 C.F.R. § 3.320 by removing such requirement. See 88 Fed. Reg. 60336 (Sept. 1, 2023). The provisions of this final rule apply to all applications for benefits that are received by VA on or after October 31, 2023, and to claims pending before VA on that date, as well as certain previously denied claims. Id.; 38 C.F.R. § 3.320.

Further, the Sergeant First Class Heath Robinson Honoring Promise to Address Comprehensive Toxins Act of 2022 (PACT Act) provides that service connection may also be established for a covered veteran with a respiratory disease associated with exposure to burn pits and other toxins, to include rhinitis and sinusitis, that was diagnosed any time after service. Under this Act, any enumerated disease becoming manifest in a covered veteran shall be considered to have been incurred in or aggravated during active military, naval, air, or space service even though there is no record of such disease during the period of such service. 38 U.S.C.

§ 1120. A covered veteran means any veteran who performed active military, naval, air, or space service while assigned to a duty station in enumerated countries in Southwest Asia on or after August 2, 1990. 38 U.S.C. § 1119.

Service connection may also be granted for a disability due to a qualifying chronic disability of a veteran who served in the Southwest Asia Theater of operations during the Persian Gulf
any time after service. Under this Act, any enumerated disease becoming manifest in a covered veteran shall be considered to have been incurred in or aggravated during active military, naval, air, or space service even though there is no record of such disease during the period of such service. 38 U.S.C.

Service connection may also be granted for a disability due to a qualifying chronic disability of a veteran who served in the Southwest Asia Theater of operations during the Persian Gulf War provided that such disability became manifest during either active service in the Southwest Asia Theater of Operations during the Persian Gulf War or to a degree of 10 percent or more, under the appropriate diagnostic code of 38 C.F.R. Part 4, not later than December 31, 2026, and by history, physical examination, and laboratory tests, the disability cannot be attributed to any known clinical diagnosis. 38 U.S.C. § 1117; 38 C.F.R.

§ 3.317 (a)(1).

Pursuant to the PACT Act, as of August 10, 2022, the foregoing statute and regulation has been amended to indicate that such disability must become manifest to any degree at any time.

A chronic qualifying disability means a chronic disability resulting from an (A) undiagnosed illness; (B) the following medically unexplained chronic multisymptom illnesses (MUCMIs) that are defined by a cluster of signs or symptoms: (1) CFS; (2) fibromyalgia; (3) functional gastrointestinal disorders (excluding structural gastrointestinal diseases), which includes IBS; or (4) any other illness that the Secretary determines meets the criteria in paragraph (a)(2)(ii) of this section for a MUCMI; or (C) any diagnosed illness that the Secretary determines in regulations prescribed under 38 U.S.C. § 1117 (d) warrants a presumption of service connection. 38 C.F.R. § 3.317 (a)(2)(i).

For the purposes of this section, the term MUCMI means a diagnosed illness without conclusive pathophysiology or etiology, that is characterized by overlapping symptoms and signs and has features such as fatigue, pain, disability out of proportion to physical findings, and inconsistent demonstration of laboratory abnormalities. Chronic multisymptom illnesses of partially understood etiology and pathophysiology will not be considered medically unexplained. 38 C.F.R.

§ 3.317 (a)(2)(ii).

In the case of claims based on an undiagnosed illness under 38 U.S.C. § 1117 and 38 C.F.R. § 3.317, unlike those for direct service connection, there is no requirement of a nexus or association between the claimed disability and in-service incurrence or aggravation. Gutierrez v. Principi, 19 Vet. App. 1, 8-9 (2004). However, there must be no affirmative evidence that relates the undiagnosed illness to a cause other than being in the Southwest Asia Theater of operations during the Persian Gulf War. 38 C.F.R. § 3.317(c). If signs or symptoms have been attributed to a known clinical diagnosis in the particular veteran's case being considered, service connection may not be provided under the specific provisions pertaining to Persian Gulf veterans. VAOPGCPREC 8-98 (Aug. 3, 1998).

Pertinent to a claim for service connection, such a determination requires a finding of a current disability that is related to an injury or disease in service. Watson v. Brown, 4 Vet. App. 309 (1993); Brammer v. Derwinski, 3 Vet. App. 223, 225 (1992); Rabideau v. Derwinski, 2 Vet. App. 141, 143 (1992). Under applicable regulation, the term "disability" means impairment in earning capacity resulting from diseases and injuries and their residual conditions. 38 C.F.R. § 4.1; Hunt v. Derwinski, 1 Vet. App. 292, 296 (1991); Allen v. Brown, 7 Vet. App. 439 (1995); Saunders v. Wilkie, 886 F.3d 1356 (Fed. Cir. 2018) (the term "disability" as used in 38 U.S.C. § 1110 "refers to the functional impairment of earning capacity, not the underlying cause of said disability," and held that
141, 143 (1992). Under applicable regulation, the term "disability" means impairment in earning capacity resulting from diseases and injuries and their residual conditions. 38 C.F.R. § 4.1; Hunt v. Derwinski, 1 Vet. App. 292, 296 (1991); Allen v. Brown, 7 Vet. App. 439 (1995); Saunders v. Wilkie, 886 F.3d 1356 (Fed. Cir. 2018) (the term "disability" as used in 38 U.S.C. § 1110 "refers to the functional impairment of earning capacity, not the underlying cause of said disability," and held that "pain alone can serve as a functional impairment and therefore qualify as a disability").

In McClain v. Nicholson, 21 Vet. App. 319, 321 (2007), the Court held that the requirement of the existence of a current disability is satisfied when a claimant has a disability at the time he files his claim for service connection or during the pendency of that claim, even if the disability resolves prior to adjudication of the claim. However, in Romanowsky v. Shinseki, 26 Vet. App. 289 (2013), the Court held that when the record contains a recent diagnosis of disability prior to a claimant filing a claim for benefits based on that disability, the report of diagnosis is relevant evidence that the Board must address in determining whether a current disability existed at the time the claim was filed or during its pendency.

1. Entitlement to service connection for a neck disorder.

The Veteran contends that he has a neck disorder due, generally, to an in-service event or injury. However, the Veteran's service treatment records (STRs) are negative for complaints, treatment, or diagnoses referrable to a neck disability and, in a February 1999 Occupational Health History Questionnaire completed in conjunction with the Veteran's termination from active-duty, the Veteran denied experiencing any joint pain. Moreover, the Veteran's post-service treatment records are likewise negative for complaints, treatment, or diagnoses referrable to a neck disability.

Moreover, while the Veteran is competent to report pain in his neck, he is not competent, as a lay person to diagnose a neck disability as such requires the administration and interpretation of clinical evaluations and diagnostic testing. See Jandreau v. Nicholson, 491 F.3d 1372 (Fed. Cir. 2007); Woehlaert v. Nicholson, 21 Vet. App. 456 (2007). Furthermore, he does not contend, and the evidence does not show, that his reported neck symptomatology results in impairment of earning capacity.

In this regard, the Board acknowledges that an examination and/or opinion addressing the nature and etiology of the Veteran's claimed neck disorder has not been obtained. However, the Board finds that, as the probative evidence does not demonstrate an in-service injury to the neck and/or a current disability of such disorder beyond the Veteran's own generalized lay statements, VA's duty to assist in providing a VA examination and/or opinion is not triggered. McLendon v. Nicholson, 20 Vet. App. 79 (2006); Bardwell v. Shinseki, 24 Vet. App. 36 (2010) (if there is no credible evidence establishing that an event, injury, or disease occurred in service, VA is not required to provide a medical examination); Waters v. Shinseki, 601 F.3d 1274, 1278 (2010) (a mere conclusory generalized lay statement that a service event or illness caused the Veteran's current disorder is insufficient to require the Secretary to provide an examination).

Based on the foregoing, the Board finds that at no time during the pendency of the claim does the Veteran have a current diagnosis of a neck disorder, and the record does not contain a recent diagnosis of such disability prior to the Veteran's filing of a claim. See McClain, supra; Romanowsky, supra. Thus, where, as here, there is no probative evidence indicating that the Veteran has the disability for which service connection is sought, there can be no valid claim for service connection. See Brammer, supra. Consequently, service connection for a neck disorder is not warranted.

In reaching this decision, the Board has considered the applicability of the benefit of the doubt doctrine. However, as the weight of the probative evidence is against the Veteran's claim for service connection for a neck disorder, such doctrine is not applicable in the instant appeal and his claim must be denied. 38 U.S.C. § 5107; 38 C.F.R. § 3.102.

2. Entitlement to service connection for a back disorder.

The Veteran generally contends that service connection is warranted for a back
evidence indicating that the Veteran has the disability for which service connection is sought, there can be no valid claim for service connection. See Brammer, supra. Consequently, service connection for a neck disorder is not warranted.

2. Entitlement to service connection for a back disorder.

The Veteran generally contends that service connection is warranted for a back disorder. In this regard, the Veteran's STRs reflect a September 1996 complaint that the Veteran twisted his lower back during firefighting training. Despite this reported in-service energy, subsequent August 1997 and February 1999 Occupational Health History Questionnaires reflect that the Veteran consistently denied any back or joint pain. Similarly, post-service treatment records are likewise negative for any treatment for a back disorder.

Nevertheless, in July 2024 the Veteran attended a private medical examination with A.H., a board-certified nurse practitioner. Therein, the Veteran reported that he was seen in-service for a back injury and that his back pain has increased in severity since such time. The private examiner assessed that the Veteran has a lumbosacral strain.

In a corresponding opinion, A.H. assessed that his current lumbosacral strain is due to his active duty service. However, her opinion is conclusory and she provides no rationale for her opinion. Nieves-Rodriguez v. Peake, 22 Vet. App. 295 (2008) (it is the factually accurate, fully articulated, sound reasoning for the conclusion that contributes to the probative value of a medical opinion); Stefl v. Nicholson, 21 Vet. App. 120, 124 (2007) ("[A]medical opinion ... must support its conclusions with an analysis that the Board can consider and weigh against contrary opinions"). Rather, she recites VA law relative to the requirements for service connection, lists lay statements made by the Veteran, and cites a study relative to chronic pain, generally, among service members, without relating how this study relates specifically to the Veteran's case and condition. See Dennis v. Nicholson, 21 Vet. App. 18, 22 (2007) ("The Court has long held that merely listing evidence before stating a conclusion does not constitute an adequate statement of reasons and bases"); see also Bailey v. O'Rourke, 30 Vet. App. 54, 60 (2018) (a medical opinion that relies on general medical literature without discussing the specific facts of the case is inadequate). Therefore, the Board finds the July 2024 private opinion an inadequate basis to award service connection.

In light of the in-service notation of a back injury and the July 2024 private examination, coupled with the inadequacies of the July 2024 private opinion, the AOJ ordered a VA examination so as to determine the presence and etiology of such claimed disorder. However, in March 2025, the Veteran contacted the AOJ noting that VA has "all information needed to make a decision" and requested that the AOJ proceed with processing his claims without any additional C&P exams, and the Veteran indeed failed to attend the scheduled examination. Wamhoff v. Brown, 8 Vet. App. 517, 522 (1996) (the duty to assist in the development and adjudication of a claim is not a one-way street); Wood v. Derwinski, 1 Vet. App. 190, 193, reconsideration denied, 1 Vet. App. 406 (1991) (per curiam) (if a veteran wishes help, he cannot passively wait for it in circumstances where he may or should have evidence that is essential in obtaining the putative evidence).

38 C.F.R. § 3.655(a) provides that, when entitlement to a benefit cannot be established without a current VA examination or reexamination and a claimant, without good cause, fails to report for such examination or reexamination, action shall be taken in accordance with 38 C.F.R. § 3.655 (b) or (c) as appropriate. With regard to the instant case, 38 C.F.R. § 3.655(b) provides that, when a claimant fails to report for an examination scheduled in conjunction with an original compensation claim, the claim shall be rated based on the evidence of record. Thus, the Veteran's claim must be adjudicated on the evidence of record, which fails to reflect both complaints, treatment, or diagnoses referrable to
when entitlement to a benefit cannot be established without a current VA examination or reexamination and a claimant, without good cause, fails to report for such examination or reexamination, action shall be taken in accordance with 38 C.F.R. § 3.655 (b) or (c) as appropriate. With regard to the instant case, 38 C.F.R. § 3.655(b) provides that, when a claimant fails to report for an examination scheduled in conjunction with an original compensation claim, the claim shall be rated based on the evidence of record. Thus, the Veteran's claim must be adjudicated on the evidence of record, which fails to reflect both complaints, treatment, or diagnoses referrable to a back disorder, as well as an adequate medical opinion relaying his in-service injury to his current disability.

Furthermore, the Veteran, as a lay person, is not competent to address the etiology of his back disorder as such involves a complex medical subject concerning an internal physical process extending beyond an immediately observable cause-and-effect relationship. See Jandreau, supra (holding that a lay person is not considered competent to testify regarding medically complex issues); Woehlaert, supra (holding that, although the claimant is competent in certain situations to provide a diagnosis of a simple condition such as a broken leg or varicose veins, the claimant is not competent to provide evidence as to more complex medical questions). Thus, his opinion in such regard is afforded no probative weight.

Based on the foregoing, the Board finds that a back disorder is not shown to be causally or etiologically related to any disease, injury, or incident during service. Thus, service connection for such disorder is not warranted.

In reaching this decision, the Board has considered the applicability of the benefit of the doubt doctrine. However, as the weight of the probative evidence is against the Veteran's claim for service connection for a back disorder, such doctrine is not applicable in the instant appeal and his claim must be denied. 38 U.S.C. § 5107; 38 C.F.R. § 3.102.

3. Entitlement to service connection for rhinitis.

4. Entitlement to service connection for sinusitis.

Issues 3-4:

The Veteran contends that he developed rhinitis and sinusitis as a direct result of his active-duty service. Initially, the Board notes that the AOJ favorably found that the Veteran has a current diagnosis of both rhinitis and sinusitis and that he was exposed to toxic chemicals during his service, as identified in a March 2023 VA Memorandum as firefighting foam, vehicle fuels, and vehicle exhaust. See March 2023 Toxic Exposure Risk Activity (TERA) Memorandum. The Board is bound by these favorable findings in the AMA. 38 C.F.R. § 3.104(c).

The Veteran's STRs reflect a single December 1998 assessment of viral sinusitis. However, a February 1999 Occupational Health History Questionnaire completed in anticipation of termination from active duty reflects that the Veteran denied experiencing ear, nose, or throat trouble. Thereafter, however, the record is negative for any post-service treatment records referrable to rhinitis or sinusitis.

The Veteran submitted a private opinion from A.H., a board-certified nurse practitioner, indicating service connected is warranted for rhinitis and sinusitis. However, for the reasons set forth in detail below, the Board can assign it no probative value.

Initially, A.H. asserts that the Veteran meets the criteria for presumptive service connection for a "chronic multi symptom illness," based on his deployment to Southwest Asia. The Board can only presume that the private examiner meant that the Veteran meets the criteria for a medically unexplained chronic multi-symptom illness (MUCMI). In this regard, as explained above, the term MUCMI means a diagnosed illness without conclusive pathophysiology or etiology that is characterized by overlapping symptoms and signs and has features such as fatigue, pain, disability out of proportion to physical findings, and inconsistent demonstration of laboratory abnormalities. However, the Board observes that A.H. made no findings relative to these symptoms and, within the same opinion, attributes the Veteran's rhinitis and sinusitis diagnoses to his exposure to toxic chemicals he was exposed to coincident with his MOS as a fire-fighter. More importantly, the Board notes that only veterans with service in those places enumerated by statute are eligible for the presumptive service connection provisions of 38 C.F.R. 3.317. To clarify, it is limited to only those veterans with active military, naval, or air service in the Southwest Asia theater of operations. In this regard, while the Veteran is a Persian Gulf War era veteran, he did not serve in the Southwest Asia theater of operations, or the airspace above,
the Board observes that A.H. made no findings relative to these symptoms and, within the same opinion, attributes the Veteran's rhinitis and sinusitis diagnoses to his exposure to toxic chemicals he was exposed to coincident with his MOS as a fire-fighter. More importantly, the Board notes that only veterans with service in those places enumerated by statute are eligible for the presumptive service connection provisions of 38 C.F.R. 3.317. To clarify, it is limited to only those veterans with active military, naval, or air service in the Southwest Asia theater of operations. In this regard, while the Veteran is a Persian Gulf War era veteran, he did not serve in the Southwest Asia theater of operations, or the airspace above, at any time. See March 2025 TERA Memorandum; DD 214 (showing no foreign service); see also Reonal v. Brown, 5 Vet. App. 458, 461 (1993) (medical expert opinion formed on the basis of erroneous or incomplete facts, deprives the opinion of significant probative weight and yields very little to no probative value).

Furthermore, the private examiner's opinion that a manifestation of sinusitis and rhinitis within 10 years of his exposure to toxic chemicals warrants presumptive service connection is also an incorrect statement of the law. In this regard, as noted above, the presumptive provisions regarding sinusitis and rhinitis are for those veterans who served in the Southwest Asia theater of operations, which to reiterate, this Veteran did not. Id.

These, unfortunately, are not the only problems with the private opinion. In this regard, the Board observes that the private examiner does not provide a basis or rationale for her opinion. Nieves-Rodriguez v. Peake, 22 Vet. App. 295 (2008) (it is the factually accurate, fully articulated, sound reasoning for the conclusion that contributes to the probative value of a medical opinion); Stefl v. Nicholson, 21 Vet. App. 120, 124 (2007) ("[A]medical opinion ... must support its conclusions with an analysis that the Board can consider and weigh against contrary opinions").

Based upon these inadequacies in the medical opinion, the Board cannot make informed decisions regarding whether the Veteran's rhinitis and sinusitis are related to his active duty service, to include whether his exposure to toxic chemicals coincident with his military occupational specialty (MOS) caused him to develop such disabilities.

In light of these deficiencies in the private opinion, the AOJ ordered a VA Rhinitis and Sinusitis examination to assess the nature and etiology of such disorders. However, in March 2025, the Veteran contacted the AOJ noting that VA has "all information needed to make a decision" and requested that the AOJ proceed with processing his claims without any additional C&P exams, and the Veteran indeed failed to attend the scheduled examination. Wamhoff, supra; Wood, supra.

The Board has also considered the Veteran's assertions that he has rhinitis and sinusitis related to his military service. However, as a lay person, he does not have the requisite training and experience necessary to address the etiology of such claimed disorders. Jandreau v. Nicholson, 491 F.3d 1372 (Fed. Cir. 2007) (noting general competence to testify as to symptoms but not to provide medical diagnosis). In this regard, the diagnosis and etiology of such disorders involve a medical subject concerning an internal physical process extending beyond an immediately observable cause-and-effect relationship and, thus, may not be competently addressed by lay statements. See Woehlaert, supra. Accordingly, the Veteran's opinion as to the diagnosis and etiology of his claimed rhinitis and sinusitis is not competent evidence and, consequently, is afforded no probative weight.

Based on the foregoing, the Board finds that rhinitis and sinusitis are not shown to be causally or etiologically related to any
3d 1372 (Fed. Cir. 2007) (noting general competence to testify as to symptoms but not to provide medical diagnosis). In this regard, the diagnosis and etiology of such disorders involve a medical subject concerning an internal physical process extending beyond an immediately observable cause-and-effect relationship and, thus, may not be competently addressed by lay statements. See Woehlaert, supra. Accordingly, the Veteran's opinion as to the diagnosis and etiology of his claimed rhinitis and sinusitis is not competent evidence and, consequently, is afforded no probative weight.

Based on the foregoing, the Board finds that rhinitis and sinusitis are not shown to be causally or etiologically related to any disease, injury, or incident during service. Thus, service connection for such disorders is not warranted.

In reaching this decision, the Board has considered the applicability of the benefit of the doubt doctrine. However, as the weight of the probative evidence is against the Veteran's claims for service connection for rhinitis and sinusitis, such doctrine is not applicable in the instant appeal and his claims must be denied. 38 U.S.C.

§ 5107; 38 C.F.R. § 3.102.

5. Entitlement to service connection for migraine headaches.

The Veteran asserts that service connection for migraine headaches is warranted. As an initial matter, the Board notes that the AOJ favorably found that the Veteran has a current diagnosis of migraine headaches and that he was exposed to toxic chemicals during his service, as identified in a March 2023 VA Memorandum as firefighting foam, vehicle fuels, and vehicle exhaust. See March 2023 Toxic Exposure Risk Activity (TERA) Memorandum. The Board is bound by these favorable findings in the AMA. 38 C.F.R. § 3.104(c).

Furthermore, the Veteran's STRs reflect a July 1998 treatment note reflecting that the Veteran fell from a boat, hit his head, and was experiencing headaches as a result, followed by an August 1999 notation indicating the Veteran complained of migraine headaches. However, a February 1999 Occupational Health History Questionnaire completed in anticipation of termination from active duty reflects that the Veteran denied frequent or severe headaches. Thereafter, the record is negative for any post-service treatment records referrable to migraine headaches until July 2024, wherein he was diagnosed by a private examiner.

The Veteran submitted a July 2024 private opinion by A.H., who assessed that the Veteran's migraine headaches are due to his active-duty service. Specifically, she opines that the Veteran's migraine headaches are "chronic" pursuant to the provisions of 38 C.F.R. § 3.309, in that they started in-service in 1996 and have continued to present. Unfortunately, for the reasons set forth below, the Board finds A.H.'s July 2024 private opinion inadequate for adjudication purposes.

Initially, the Board notes that the examiner's opinion, in part, relies on incorrect factual information. See Reonal, supra. In this regard, she notes that there is "an absence of service treatment records" for migraine headaches "due to the fact that he did not report headaches in service." However, a review of the Veteran's STRs, as noted above, reflects multiple complaints of headaches/migraines during his active-duty service in 1998 and 1999. Moreover, A.H. does not provide an opinion as to whether the Veteran's in-service exposure to firefighting foam and vehicle exhaust/fuels are at least as likely as not to have caused him to develop migraine headaches.

Finally, A.H's opinion is conclusory and lacks a sufficient rationale to support an award of service connection. See Nieves-Rodriguez, supra; Steffl, supra. In this regard, A.H. notes that the Veteran states that he began experiencing migraines in service, he continued to experience what he believes to be migraines thereafter, and continues to experience them to present day. She does not elicit information from the Veteran about what symptoms he experienced post-active-duty to present that would support her finding of continuity of symptomatology, as further discussed below.

Based upon these inadequacies in the medical opinion, the Board cannot make informed decisions regarding whether the Veteran's migraine headaches are related to his active duty service, to include whether his exposure to toxic chemicals coincident with his MOS caused him to develop such disabilities, or whether his diagnosed migraine headaches have been chronic pursuant to the terms of 38 C.F.R. § 3.307.

Due to these inadequacies, the AOJ ordered a VA examination so as to determine the nature and etiology of such claimed disorder. However, in March 2025, the Veteran contacted the AOJ noting that VA has "all information needed to make a decision
present that would support her finding of continuity of symptomatology, as further discussed below.

Due to these inadequacies, the AOJ ordered a VA examination so as to determine the nature and etiology of such claimed disorder. However, in March 2025, the Veteran contacted the AOJ noting that VA has "all information needed to make a decision" and requested that the AOJ proceed with processing his claims without any additional C&P exams, and the Veteran indeed failed to attend the scheduled examination. Wamhoff, supra; Wood, supra.

Nevertheless, the Board has considered whether presumptive service connection for such disorder is warranted based on chronicity and/or a continuity of symptomatology. Specifically, 38 C.F.R. § 3.303(b) states that, with a chronic disease shown as such in service (or within the presumptive period under § 3.307) so as to permit a finding of service connection, subsequent manifestations of the same chronic disease at any later date, however remote, are service connected, unless clearly attributable to intercurrent causes. For the showing of chronic disease in service there is required a combination of manifestations sufficient to identify the disease entity, and sufficient observation to establish chronicity at the time, as distinguished from merely isolated findings or a diagnosis including the word "chronic."

Continuity of symptomatology is required only where the condition noted during service (or in the presumptive period) is not, in fact, shown to be chronic or where the diagnosis of chronicity may be legitimately questioned. Continuity of symptomatology may be established if the claimant case demonstrate (1) that a condition was "noted" during service; (2) evidence of post-service continuity of the same symptomatology; and (3) medical, or in certain circumstances, lay evidence of a nexus between the present disability and post-service symptoms. See Savage v. Gober, 10 Vet. App. 488, 495 (1997).

Here, as discussed above, there is cause to legitimately question A.H.'s finding that the Veteran's diagnosed migraine headaches are "chronic" in nature. Notably, as discussed above, A.H. did not elicit a history from the Veteran to warrant a finding that such manifested to a degree of 10 percent within a year of discharge from active-duty, nor did she opine that such became manifest to a degree of 10 percent within a year of discharge. Additionally, in the year following the Veteran's discharge from active duty, his medical treatment records are negative for any objective complaints, treatment, or diagnoses referrable to migraine headaches. In this regard, the Board notes the Veteran sought treatment for other conditions during this time per medical records but did not report any headaches.

Therefore, to warrant an award of service connection on a presumptive basis, there must be a showing of continuity of symptomatology. While the condition was noted in service, and the Veteran now alleges the same symptomatology from his discharge to present, the Board observes that the medical evidence of record reflects that the Veteran denied experiencing frequent or severe headaches in February 1999 and post-service treatment records are negative for complaints, treatment, or diagnoses referrable to migraines. Furthermore, the only medical opinion of record indicating that the Veteran's migraine headaches are chronic, fails to provide a rationale for her positive nexus opinion that the Veteran's present disability, migraine headaches, are related to his claimed post-service symptoms. Notably, there is no other clinical evidence of record, other
an award of service connection on a presumptive basis, there must be a showing of continuity of symptomatology. While the condition was noted in service, and the Veteran now alleges the same symptomatology from his discharge to present, the Board observes that the medical evidence of record reflects that the Veteran denied experiencing frequent or severe headaches in February 1999 and post-service treatment records are negative for complaints, treatment, or diagnoses referrable to migraines. Furthermore, the only medical opinion of record indicating that the Veteran's migraine headaches are chronic, fails to provide a rationale for her positive nexus opinion that the Veteran's present disability, migraine headaches, are related to his claimed post-service symptoms. Notably, there is no other clinical evidence of record, other than the Veteran's own statements, to support a finding that the Veteran continuously experienced headaches since his discharge from active-duty service.

Furthermore, the Veteran, as a lay person, is not competent to address the etiology of his migraine headaches as such involves a complex medical subject concerning an internal physical process extending beyond an immediately observable cause-and-effect relationship. See Jandreau, supra (holding that a lay person is not considered competent to testify regarding medically complex issues); Woehlaert, supra (holding that, although the claimant is competent in certain situations to provide a diagnosis of a simple condition such as a broken leg or varicose veins, the claimant is not competent to provide evidence as to more complex medical questions). Thus, his opinion in such regard is afforded no probative weight.

Based on the foregoing, the Board finds that migraine headaches are not shown to be causally or etiologically related to any disease, injury, or incident during service. Thus, service connection for such disorder is not warranted.

In reaching this decision, the Board has considered the applicability of the benefit of the doubt doctrine. However, as the weight of the probative evidence is against the Veteran's claim for service connection for migraine headaches, such doctrine is not applicable in the instant appeal and his claim must be denied. 38 U.S.C.

§ 5107; 38 C.F.R. § 3.102.

A. Dean

Acting Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board Deal, Katie

The Board's decision in this case is binding only with respect to the instant matter decided. This decision is not precedential and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303.

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